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General NPI Number Information
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NPI Number | 1548420417
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Entity Type | Organization
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Legal Business Name | ATA O MOSHYEDI MD PA
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Dates
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Enumeration Date | 06/13/2008
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Last Update Date | 06/13/2008
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Provider Practice Location Address
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Address Line | 7305 HANOVER PKWY SUITE A
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City | GREENBELT
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State | MD
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Zip | 20770-2030
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Country | US
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Telephone | 301-982-7900
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Fax |
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Provider Business Mailing Address
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Address Line | 7305 HANOVER PKWY SUITE A
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City | GREENBELT
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State | MD
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Zip | 20770-2030
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Country | US
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Telephone | 301-982-7900
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ATA O MOSHYEDI
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Credential | MD
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Telephone | 301-805-4586
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | D0009179
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | D0046093
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License Number State | MD
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